MEDICARE: MS. DEBRA DARLENE TOBIAS ACE PERSONAL TRAINER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1598903312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBRA DARLENE TOBIAS ACE PERSONAL TRAINER

Provider Business Mailing Address
First Line	:	2327 E PRECIOUS SHARD CT
Second Line	:
City	:	ORO VALLEY
State	:	AZ
Zip	:	85755-1955
Country	:	US
Telephone Number	:	520-780-8207
Fax Number	:

Provider Business Practice Location Address
First Line	:	2327 E PRECIOUS SHARD CT
Second Line	:
City	:	ORO VALLEY
State	:	AZ
Zip	:	85755-1955
Country	:	US
Telephone Number	:	520-780-8207
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2009
Last Update Date	:	02/02/2009

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